The Role of PUBLIC EDUCATION in a Comprehensive Canadian Strategy KM Morrison, Department of Pediatrics, McMaster University
Jan 12, 2016
The Role of PUBLIC EDUCATION in a Comprehensive Canadian Strategy
KM Morrison, Department of Pediatrics, McMaster University
Objectives
Be aware of current knowledge of the public on obesity related themes
Be familiar with available sources of public education on obesity
Understand the role of physicians in contributing to public education
Be able to identify strategies for effective communication
Where are we now?
The answer depends on whether the questions relates to knowledge of what to do – or skills of how to do it
Sanderson, 2009
Most adults in the UK are aware of the relationship of lifestyle behaviours to heart disease
Actions taken to lower personal and family members’ risk of heart disease in the previous year.
Mosca L et al. Circulation 2006;113:525-534
Copyright © American Heart Association
Survey in 1008 women -- USA
Facilitators for implementing change?
“Awareness of personal risk”
Mosca L et al. Circulation 2006;113:525-534
Barriers to NOT implementing change?
“Media is too confusing” 49%
“Health is determined by a higher power” 40%
“Caretaking responsibilities” 37%
Mosca L et al. Circulation 2006;113:525-534
According to Angelo A. Alonzo, professor of medical sociology, Ohio State University, information overload may be one reason why people choose not to adopt healthier lifestyles.
Due to the vast amount of medical information inundating the public every day….
"Health educators may well face a significantly desensitized population, segments of which are immobilized by fear, indecision, and confusion."
Sources of information on healthy lifestyle
INTERNET23 MILLION HITS
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COMMUNITY
Entertainment
PRINT MEDIA
Influence of social connections on obesity development
Christakis, NEJM, 2007
• Framingham Offspring Study
• Utilized information at each of 7 visits relating to family members and friends
Influence of type of social connection
Influence of geography
Sources of information on healthy lifestyle
INTERNET23 MILLION HITS
Advertisements
COMMUNITY
Entertainment
PRINT MEDIA
PHYSICIANS?
Hippocrates: “let thy food be thy medicine”
Canadian’s experience Kirk etal Telephone survey of 2004 Canadians conducted
by Ipsos Reid – March/April 2009
80% urban, 20% rural dwellers from across Canada
32% were overweight, 21% were obese based on self reported height and weight
40% of overweight thought their weight was “about right”
Canadian’s experience Kirk etal 50 – 71% of overweight or obese adults had tried
to lose weight in the preceding 12 months....
Only 13% of overweight and 35% of obese had asked a physician for help with weight management in the last 12 months (25 and 58% ever)
30% of overweight and obese adults had been advised by their physician to “lose weight”
Kirk SF, Chronic Diseases and Injuries in Canada, 2012
Copyright © American Heart Association
Parental perception of child’s weight status
Measured BMI in Canadian school age childrenn=384He et al Canadian Family Physician
Parental perception of weight status in 2 – 5 year olds – Northern OntarioDo you think your child is underweight, normal weight or overweight?
Do you think your child’s weight might impact their future health?
Tijssen,CPS, 2011
0%10%20%30%40%50%60%70%80%90%
100%
Classification of weight status (WHO)
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Risk o
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Overw
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0%10%20%30%40%50%60%70%80%90%
100%
Classification of Child's Weight status (WHO)
Pa
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UNDER NORMAL OVERWEIGHT
Sharma AM. M, M, M & M: a mnemonic for assessing obesity. Obes Rev. 2010;11:808-9.
Educating the Public – Policy Implications
“For the most part however, the reliance upon scientific and usually quantitative knowledge by health promoters… has led to an emphasis on lifestyle issues that potentially detract attention from the political and socioeconomic issues that influence health and well-being” --Toba Bryant, Health Promotion International, 2002
“although individual behaviour does contribute to health and disease, social organization is perhaps a more powerful influence”
--Freudenberg, Health Education Monographs, 1978
Spiral of causation
CHILD
FAMILY
COMMUNITY
INDUSTRY
GOVERNMENT(s)
Knowledge to advance policy change
Development of a fundamental new direction in policy
Influenced by knowledge
Requires knowledge of different types – and from different groups
Paradigmatic policy change
Management: One step at a time!
GOAL SETTING – Must be realistic!
Focused on behavioural change!
Be part of the solution!
Support safe walking (School bus, shopping, recreation, community)
Be a voice for community
Be a voice in schools
Be a role model for all the children in your life!